title: Fatty acids and other risk factors for sudden cardiac death in patients starting hemodialysis.
abstract: BACKGROUND
  Little is known about risk factors for sudden cardiac death in hemodialysis patients during the high-risk first year of dialysis. We therefore undertook to identify such risk factors in a nationally representative cohort and were able to include baseline levels of blood fatty acids, some of which influence arrhythmogenicity and sudden cardiac death risk.
  
  
  METHODS
  The study cohort included 100 patients who died of sudden cardiac death during the first year of hemodialysis and 300 frequency-matched controls. Using the elastic net statistical method, numerous demographic and clinical characteristics were included with baseline total serum levels for 11 major fatty acids (model 1) and with serum phospholipid fractions of these same fatty acids (model 2). Final models included only covariates that had a non-zero coefficient.
  
  
  RESULTS
  In model 1, serum albumin [odds ratio (95% CI): 0.55 (0.33-0.93); p = 0.03] and total serum long-chain n-3 docosapentaenoic acid [0.70 (0.51-0.97); p = 0.03] were inversely associated with the odds of sudden cardiac death, while the total serum saturated fatty acid level had a direct association [1.01 (1.00-1.02); p = 0.03]. In model 2, serum albumin and docosapentaenoic acid remained inversely associated with sudden cardiac death in a similar manner as in model 1. Pulse pressure also had an inverse association [0.96 (0.93-1.00); p < 0.05].
  
  
  CONCLUSIONS
  Several factors, including blood content of docosapentaenoic acid and saturated fatty acids, were associated with the odds of sudden cardiac death during year one of hemodialysis. These results raise the possibility that dietary modification may reduce sudden death risk.
authors.affiliation: Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. allfried@iupui.edu
authors.forename: Allon N
authors.initials: AN
authors.lastname: Friedman
authors.forename: Zhangsheng
authors.initials: Z
authors.lastname: Yu
authors.forename: Cheryl
authors.initials: C
authors.lastname: Denski
authors.forename: Hector
authors.initials: H
authors.lastname: Tamez
authors.forename: Julia
authors.initials: J
authors.lastname: Wenger
authors.forename: Ravi
authors.initials: R
authors.lastname: Thadhani
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.forename: Bruce
authors.initials: B
authors.lastname: Watkins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016718:Arachidonic Acid / Q000097:blood; D001145:Arrhythmias, Cardiac / Q000401:mortality*; D016022:Case-Control Studies; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D005227:Fatty Acids / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D012709:Serum Albumin
chemical_list: D005227:Fatty Acids; D005231:Fatty Acids, Unsaturated; D012709:Serum Albumin; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid; C026219:docosapentaenoic acid